Individual provider Active NPI

Jennifer Marie Watts, ARNP

  • Acute Care Nurse Practitioner
  • Titusville, FL
National Provider Identifier
1699277673
Registry record updated Apr 20, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Acute Care Nurse PractitionerTaxonomy code 363LA2100X
License
9314133 Issued in FL
Practice address
951 N Washington Ave
Titusville, FL 32796-2163
Phone
(321) 268-6470
NPI assigned
Mar 6, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 20, 2021

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Acute Care Nurse Practitioner 363LA2100X 9314133 FL Primary

Addresses

Primary practice location

951 N Washington Ave
Titusville, FL 32796-2163

Mailing address

4760 Pawnee TRL
Merritt Island, FL 32953-7826

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180628003108 FL Practitioner - Nurse Practitioner 9133475460 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
North Brevard Medical Support IncGroup PAC ID 7618870296, 62 clinicians

Practice addresses (Care Compare)

951 N Washington Ave
Titusville, FL 32796-2163
Phone (321) 268-6834

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
86.02 of 100Reported as group
Quality
75.26
Promoting interoperability
100
Improvement activities
40
Cost
78.14

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
9314133FLMDAcute Care Nurse Practitioner

Interoperability endpoints

  • Direct secure messaging: jennifer.watts.1@17832.direct.athenahealth.com

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1520294400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1618876800000",
    "number": "1699277673",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4760 PAWNEE TRL",
            "city": "MERRITT ISLAND",
            "state": "FL",
            "postal_code": "329537826"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "951 N WASHINGTON AVE",
            "city": "TITUSVILLE",
            "state": "FL",
            "postal_code": "327962163",
            "telephone_number": "321-268-6470"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WATTS",
        "first_name": "JENNIFER",
        "middle_name": "MARIE",
        "credential": "ARNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-03-06",
        "last_updated": "2021-04-20",
        "certification_date": "2021-04-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "FL",
            "license": "9314133",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Titusville, FL

Sources for this page

Verify at the official NPI Registry.